[Bilateral retroperitoneal lymphadenectomy in tumors of the testis: anatomo-clinical considerations].
Bilateral retroperitoneal lymphadenectomy is usually indicated for non-seminomatous testis tumour at stage IIA and IIB. For seminoma is generally used radiotherapy, although some Authors prefer the surgical approach. Radical retroperitoneal lymphadenectomy must be bilateral, because metastatic cell can often spread to the contralateral lymph nodes. Lymphadenectomy is used not only for therapy, but also for staging: thus clinical evaluation and other diagnostic techniques are not always correct (30% of understaging). Permanent sexual disfunction can follow radical surgery, due to extensive retroperitoneal dissection and exeresis of lumbar sympathetic nerves; so it is proposed, for stage I tumors, a monolateral or limited retroperitoneal lymphadenectomy. Eight patients with non-seminomatous testicular tumours are reported by the authors; 2 (stage I) were treated with monolateral, 4 (stage IIA and IIB) with bilateral retroperitoneal lymphadenectomy; in 2 patients (stage IIC and IID) chemotherapy was followed by debulking surgery. Relapses were observed between 3 and 19 months. Sexual dysfunctions after surgery were present in 5 patients (69%); in all of these a bilateral retroperitoneal lymphadenectomy was performed.
Martinelli
V
V
IV Clinica Chirurgica, Università degli Studi di Roma La Sapienza.
Piermattei
A
A
Merli
L
L
Egidi
A
A
Pulcini
M
M
Angelici
A
A
D000293:Adolescent; D000328:Adult; D004407:Dysgerminoma / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D011183:Postoperative Complications; D013724:Teratoma / Q000601:surgery*; D013736:Testicular Neoplasms / Q000601:surgery*; D013997:Time Factors
La linfadenectomia retroperitoneale bilaterale nei tumori del testicolo: considerazioni anatomo-cliniche.